THE URINARY SYSTEM

Introduction

 Urology is the branch of medicine that deals

with the urinary system.

 There are three functions of the urinary

system:
 Regulates volume, composition, and pH of body fluids.
 Excretes metabolic wastes.
 Regulates blood pressure, RBC production, synthesizes
calcitriol, and performs gluconeogenesis.
 Basic Gross Anatomy
 Two kidneys

 Two ureters

 Urinary bladder

 Urethra
 External Anatomy of the Kidneys
 Within the muscular
wall of the back
between T12-L3.
 Renal hilus
 Connective tissue
layers:
 Renal capsule
 Adipose capsule
 Renal fascia
 Internal Anatomy of the Kidneys
 Renal Cortex
 Renal Medulla
 Renal pyramids
 Renal papillae
 Renal columns
 Renal Pelvis
 With major calyces
and minor calyces
Blood Supply of the Kidney
 Nephron Anatomy
 Renal Corpuscle
 Glomerulus
 Bowman’s capsule
 Renal Tubules
 Proximal convoluted
tubule (PCT)
 Loop of Henle
 Distal convoluted
tubule (DCT)
Renal Corpuscle
Filtration Membrane
Podocytes
Filtration Membrane
Renal Tubules
Renal Tubules
 Types of Nephrons

 Cortical
Nephrons

 Juxtamedullary
nephrons
Renal Physiology

Occurs in Three Steps:

Non-selective filtration
Tubular reabsorption
Tubular secretion
NON-SELECTIVE FILTRATION

Step 1
Renal Physiology
Non-Selective Filtration
Glomerular Filtration Rate
REABSORPTION

Step 2A
Tubular Reabsorption
Tubular Reabsorption
Tubular Reabsorption
 Tubular Reabsorption at the PCT
 Glucose, lactate, amino acids and vitamins
– 100%
 Bicarbonate ions – 90%
 Water and sodium ions – 65%
 Potassium ions – 55%
 Chloride ions – 50%
 Others are hormonally controlled
Tubular Reabsorption
Tubular Reabsorption
Countercurrent Mechanism
Tubular Reabsorption
 Tubular Reabsorption at the Loop
 Chloride – 35%
 Potassium – 30%
 Sodium ions – 25%
 Water – 10%
Tubular Reabsorption
Tubular Reabsorption
 Tubular Reabsorption at the DCT
 Water – 25%
 Chloride – 10%
 Sodium ions – 10%
Tubular Reabsorption
Tubular Reabsorption
SECRETION

Step 2B
Tubular Secretion
 Regulation by Hormones

 Antidiuretic hormone (ADH)

 Aldosterone

 Atrial natriuretic peptide (ANP)

 Renin and Angiotensin II

 Urine Formation
 Urine composition
 90-95% water
 Solutes constitute the other 5%
 Metabolic wastes (urea, uric acid, and creatinine)
 Ions (Na+, K+, PO43-, SO42-, Ca2+, Mg2+)
 Toxins and pigments (urochrome)
 Hormones

 Urine characteristics
 Yellow in color
 Slightly aromatic or ammonia odor
 pH slightly acidic (can vary from 4.5 to 8.0)
 Specific gravity 1.001 to 1.035
Abnormal Urine Constituents
Ureters
Urinary Bladder and Urethra
Micturition
Micturition
 Homeostatic Imbalances
 Ptosis  Renal calculi
 Hydronephrosis  Urethritis
 Pyelitis  Cystitis
 Pyelonephritis  Incontinence
 Anuria & Hyperuria  Urinary retention
 Hypospadias  Horseshoe kidney
 Diabetes insipidus  Polycystic kidney
 Cystocele  Renal infarct